MEDICARE: MANAL CHEHADEH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1386272029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANAL CHEHADEH

Provider Business Mailing Address
First Line	:	5820 N CANTON CENTER RD STE 181
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-2651
Country	:	US
Telephone Number	:	877-882-4480
Fax Number	:	248-800-7272

Provider Business Practice Location Address
First Line	:	5820 N CANTON CENTER RD STE 181
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-2651
Country	:	US
Telephone Number	:	877-882-4480
Fax Number	:	248-800-7272

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2020
Last Update Date	:	06/01/2026

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Directions to “ MANAL CHEHADEH ” Practice Location

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